The fate of testicular salvage in spermatic cord torsion depends on the duration of ischemia and the degree of torsion. Even though spermatic cord torsion (SCT) can occur at any age, it is rarely reported in older patients. If the physician does not pay close attention to this unusual situation, the lack of suspicion for SCT may result in a missed or delayed diagnosis. We report a very uncommon case of missed SCT occurring in a 63-year-old man.
Delayed Diagnosis ; Humans ; Ischemia ; Middle Aged ; Spermatic Cord ; Spermatic Cord Torsion ; Testis

The HELLP syndrome, which is characterized by hemolysis, elevated liver enzymes and low platelets, complicates 4 to 14% of preeclamptic or eclamptic pregnancy. Its course is usually benign except when spontaneous hepatic rupture, a rare catastrophic event, threatens life. The authors have experienced one case of spontaneous hepatic rupture in HELLP syndrome during immediate postpartum period, which was treated with surgical intervention on the first postpartum day. We report this case with a brief review of the literatures.
Female ; HELLP Syndrome* ; Hemolysis ; Hemorrhage* ; Liver ; Postpartum Period* ; Pregnancy ; Rupture*

PURPOSE: Feeding intolerance is common in premature infants. It may extend the parenteral nutrition period and increase the risk of complications. We evaluated the efficacy of erythromycin and metoclopramide in neonates with feeding intolerance. METHODS: Between December 2006 to August 2011, 114 neonates with feeding intolerance were divided into two groups treated with either erythromycin or metoclopramide in the neonatal intensive care unit of Chung-ang University Hospital, a tertiary care center. We defined neonates with feeding intolerance as those who either could not be fully fed enterally (120 mL/kg/day) within 7 days or who skipped feeding more than twice per day because the gastric residual volume was >20% of each feed or more than 50% once. The time taken to achieve 50%, 75%, and 100% enteral feeding was estimated retrospectively. RESULTS: The erythromycin group achieved 50% feeding (P=0.047), 75% feeding (P=0.042), and 100% feeding (P=0.039) earlier than the metoclopramide group. The erythromycin group achieved 100% feeding earlier than the metoclopramide group among infants with birth weight > or =1,500 g (P=0.036) and those with gestational age > or =34 weeks (P=0.008). CONCLUSION: Compared with metoclopramide, erythromycin improves feeding in neonates with feeding intolerance, especially in infants with birth weight > or =1,500 g and in those with gestational age > or =34 weeks.
Birth Weight ; Enteral Nutrition ; Erythromycin* ; Gestational Age ; Humans ; Infant ; Infant, Newborn* ; Infant, Premature ; Intensive Care, Neonatal ; Metoclopramide* ; Parenteral Nutrition ; Residual Volume ; Retrospective Studies ; Tertiary Care Centers

PURPOSE: This study evaluated the extent of damage due to hypothermia in the mature and immature brain. METHODS: Hippocampal tissue cultures at 7 and 14 days in vitro (DIV) were used to represent the immature and mature brain, respectively. The cultures were exposed at 25degrees C for 0, 10, 30, and 60 minutes (n=30 in each subgroup). Propidium iodide fluorescent images were captured 24 and 48 hours after hypothermic injury. Damaged areas of the cornu ammonis 1 (CA1), CA3, and dentate gyrus (DG) were measured using image analysis. RESULTS: At 7 DIV, the tissues exposed to cold injury for 60 minutes showed increased damage in CA1 (P<0.001) and CA3 (P=0.005) compared to the control group at 48 hours. Increased damage to DG was observed at 24 (P=0.008) and 48 hours (P=0.011). The 14 DIV tissues did not demonstrate any significant differences compared with the control group, except for the tissues exposed for 30 minutes in which DG showed less damage at 48 hours than the control group (P=0.048). In tissues at 7 DIV, CA1 (P=0.040) and DG (P=0.013) showed differences in the duration of cold exposure. CONCLUSION: The immature brain is more vulnerable to hypothermic injury than the mature brain.
Animals ; Brain ; Dentate Gyrus ; Hippocampus ; Hypothermia, Induced* ; Neurons* ; Propidium ; Rats*

Human hairs have been known to be easily contaminated with microorganisms. This study was performed in order to measure what bacterial species and how much microorganisms contaminate human hairs in specific place. Virgin human hairs were left at 6 positions in inside corner and beside window in a laboratory for 7 days. The number of viable bacterial cells, which were determined by most probable number method, contaminating the human hairs was measured at a maximum of 10(6)/g hair and a minimum of 10(3)/g hair in inside corner and maximum of 10(6)/g hair and a minimum of 10(3)/g hair beside window. The bacterial cells-contaminating human hairs were observed via fluorescence light microscopy after 4',6-diamino-2-phenylindole (DAPI) staining. The bacterial community contaminating human hairs was analyzed via the thermal gradient gel electrophoresis (TGGE) technique, based on the diversity of the 16S-rDNA variable region. In total, approximately 20 bacterial species were detected from 12 groups of hair samples. In this study, general experimental methods-fluorescence staining, TGGE and MPN-were combined to develop new method for observation and estimation of bacteria contaminating human hairs.
Bacteria ; Electrophoresis ; Fluorescence ; Hair ; Humans ; Hypogonadism ; Light ; Microscopy ; Mitochondrial Diseases ; Ophthalmoplegia

Human hairs have been known to be easily contaminated with microorganisms. This study was performed in order to measure what bacterial species and how much microorganisms contaminate human hairs in specific place. Virgin human hairs were left at 6 positions in inside corner and beside window in a laboratory for 7 days. The number of viable bacterial cells, which were determined by most probable number method, contaminating the human hairs was measured at a maximum of 10(6)/g hair and a minimum of 10(3)/g hair in inside corner and maximum of 10(6)/g hair and a minimum of 10(3)/g hair beside window. The bacterial cells-contaminating human hairs were observed via fluorescence light microscopy after 4',6-diamino-2-phenylindole (DAPI) staining. The bacterial community contaminating human hairs was analyzed via the thermal gradient gel electrophoresis (TGGE) technique, based on the diversity of the 16S-rDNA variable region. In total, approximately 20 bacterial species were detected from 12 groups of hair samples. In this study, general experimental methods-fluorescence staining, TGGE and MPN-were combined to develop new method for observation and estimation of bacteria contaminating human hairs.
Bacteria ; Electrophoresis ; Fluorescence ; Hair ; Humans ; Hypogonadism ; Light ; Microscopy ; Mitochondrial Diseases ; Ophthalmoplegia

PURPOSE: To evaluate the feasibility and usefulness of the waist circumference-to-height ratio (WHTR) in screening for obesity in Korean children and adolescents. METHODS: Data, including body mass index (BMI), waist circumference (WC), and height, were obtained from the national growth surveys for children and adolescents in 2005. The WHTR was calculated dividing WC by height in subjects 2~18 years of age. Overweight and obese were defined by BMI percentiles for age and gender. The receiver operating characteristic (ROC) analysis was performed to find out the optimal cutoff values of WHTR that matched BMI-determined overweight and obesity using the STATA program. The area under the curve (AUC), a measure of diagnostic power, of WHTR was compared to WC. The influence of age on WHTR was analyzed by the SAS program. RESULTS: The WHTR significantly decreased with age, and had less correlation with age in the 6~18-year-old age group than the 2~5-year-old age group. Furthermore, the WHTR also had less correlation with age than WC in the 6~18-year-old age group. The AUC of WHTR in identifying overweight and obesity was significantly higher than the AUC of WC in the 6~18-year-old age group. The optimal cutoff values were 0.51 in boys and 0.49 in girls for obesity, and 0.48 in boys and 0.47 in girls for overweight, with all having the AUC>0.9. The optimal cutoff values of WHTR had a higher sensitivity for diagnosing obesity than WC> or =90th percentiles. CONCLUSION: The WHTR is an easy, accurate, and less age-dependent index with high applicability in screening for obesity in children and adolescents.
Adolescent ; Area Under Curve ; Body Mass Index ; Child ; Humans ; Mass Screening ; Obesity ; Overweight ; Phenothiazines ; ROC Curve ; Waist Circumference

PURPOSE: To evaluate the feasibility and usefulness of the waist circumference-to-height ratio (WHTR) in screening for obesity in Korean children and adolescents. METHODS: Data, including body mass index (BMI), waist circumference (WC), and height, were obtained from the national growth surveys for children and adolescents in 2005. The WHTR was calculated dividing WC by height in subjects 2~18 years of age. Overweight and obese were defined by BMI percentiles for age and gender. The receiver operating characteristic (ROC) analysis was performed to find out the optimal cutoff values of WHTR that matched BMI-determined overweight and obesity using the STATA program. The area under the curve (AUC), a measure of diagnostic power, of WHTR was compared to WC. The influence of age on WHTR was analyzed by the SAS program. RESULTS: The WHTR significantly decreased with age, and had less correlation with age in the 6~18-year-old age group than the 2~5-year-old age group. Furthermore, the WHTR also had less correlation with age than WC in the 6~18-year-old age group. The AUC of WHTR in identifying overweight and obesity was significantly higher than the AUC of WC in the 6~18-year-old age group. The optimal cutoff values were 0.51 in boys and 0.49 in girls for obesity, and 0.48 in boys and 0.47 in girls for overweight, with all having the AUC>0.9. The optimal cutoff values of WHTR had a higher sensitivity for diagnosing obesity than WC> or =90th percentiles. CONCLUSION: The WHTR is an easy, accurate, and less age-dependent index with high applicability in screening for obesity in children and adolescents.
Adolescent ; Area Under Curve ; Body Mass Index ; Child ; Humans ; Mass Screening ; Obesity ; Overweight ; Phenothiazines ; ROC Curve ; Waist Circumference

A 38-year old male patient underwent tracheal reconstruction because of a tracheal tumor. A CT scan showed that the mass was located 5 cm above the carina, the size was 2x1.5cm, and there was a 50% narrowing of the stenotic segment. After endotracheal intubation (1.D. 8mm), a pediatric suction catheter (lenght:40cm, diameter: 2mm) was inserted with a stylet at the side of the tube to pass the stenotic segment with fiberoptic bronchoscopic guidance. Conventional ventilation with an inhalation agent was performed and HFJV was started just prior to the tracheal incision. A driving gas pressure of 1 kg/cm, respiratory rate of 120/min., I:E ratio fo 1:1, and Fio2 of 1.0 were applied through the suction catheter. Ten minutes after HFJV, PaCO2showed 50mmHg. Hypercabia was relieved by increasing the driving gas pressure from 1kg/cm(2) to 1.5 kg/cm(2). HFJV was performed for one and a half hours. During the procedure, blood gas analyses were perfomed frequently and all results revealed an adequate ventilatory status. After completing the end to end anastomosis, conventional ventilation was started until surgery was ended. The patient's course proceeded uneventfully and he was discharged 13 days after surgery.
Adult ; Blood Gas Analysis ; Catheters ; High-Frequency Jet Ventilation* ; Humans ; Inhalation ; Intubation, Intratracheal ; Male ; Respiratory Rate ; Suction ; Tomography, X-Ray Computed ; Ventilation

Addisons disease is relatively rare than secondary adrenal insufficiency and result from progressive adrenocortical destruction. The common causes are idiopathic autoimmune atrophy and tuberculosis of adrenal glands. It is generally regarded as incurable in the sense that substitution therapy is required for the rest of the patients life. We report a case of tuberculous primary adrenal insufficiency which was confirmed by biopsy. This case was treated with antituberculous medication and showen to have improved adrenocortical function after six months.
Addison Disease* ; Adrenal Glands ; Adrenal Insufficiency ; Atrophy ; Biopsy ; Humans ; Tuberculosis